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General NPI Number Information
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NPI Number | 1245311208
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Entity Type | Organization
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Legal Business Name | WARD CHIROPRACTIC PC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 1616 LAFAYETTE AVE
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City | MATTOON
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State | IL
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Zip | 61938-3926
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Country | US
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Telephone | 217-234-2243
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Fax | 217-234-2253
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Provider Business Mailing Address
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Address Line | 1616 LAFAYETTE AVE
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City | MATTOON
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State | IL
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Zip | 61938-3926
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Country | US
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Telephone | 217-234-2243
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Fax | 217-234-2253
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Authorized Official
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Title or Position | PRESIDENT TREASURER
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Name | DR. TERRY ALLEN WARD
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Credential | DC
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Telephone | 217-234-2243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | IL
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